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Original Articles
The Effectiveness of an Imagery-Based Behavioral Activation Intervention for Depressive Symptoms
Sujeong Yun, Eun-Jung Shim
STRESS. 2024;32(4):204-213.   Published online December 27, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.4.204
  • 110 View
  • 5 Download
Abstract PDF
Background
Behavioral activation treatment (BAT) is an evidence-based treatment for depression. However, depressive symptoms can make it difficult to engage in activities crucial for the success of behavioral activation. Mental imagery may assist with activity engagement. This study examined the effectiveness of imagery-based BAT (BAT-I) compared to standard BAT in reducing depressive symptoms and improving behavioral activation, activity anticipation, activity motivation, and activity completion rates.
Methods
Thirty adults with moderate to severe depressive symptoms were randomly assigned to either the BAT-I or BAT groups. The participants received eight sessions of twice-weekly BAT intervention, with an additional four-eight mental imagery sessions provided for the BAT-I group.
Results
Repeated measures analysis of variance indicated that participants in both groups showed reductions in depressive symptoms and improvements in behavioral activation, activity anticipation, and activity motivation. However, the BAT-I group demonstrated significantly higher activity motivation (6.1> 5.1) and activity completion rates (93.17%>66.18%) than the BAT group.
Conclusions
While use of imagery appears to support activity engagement, further research is needed to explore how imagery can be utilized to enhance the BAT effectiveness.
The Effects of Internalized Shame and Social Exclusion on Approach-Avoidance Behavior
Jae-Yun Sim, Myoung-Ho Hyun
STRESS. 2024;32(4):171-177.   Published online December 27, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.4.171
  • 83 View
  • 8 Download
Abstract PDF
Background
This study examined the effects of internalized shame and social exclusion on approach-avoidance behavior.
Methods
A survey was conducted offline and online with 618 adult participants to assess their level of internalized shame. Among them, 59 were selected and assigned to either the high- or low-internalized shame group. These participants were then randomly assigned to either the social exclusion or inclusion condition. After experimental manipulation, explicit and implicit approach-avoidance behaviors were measured.
Results
In terms of explicit behavioral choices, the high-internalized shame group exhibited approach behavior in the social inclusion condition and avoidance behavior in the exclusion condition. In terms of explicit behavioral preferences, the high-internalized shame group and social exclusion condition exhibited avoidance responses. In terms of implicit behavior, the low-internalized shame group exhibited approach responses in the social exclusion condition, whereas the high-internalized shame group exhibited avoidance responses.
Conclusions
This study investigated the impact of internalized shame and social exclusion on social functioning and confirmed that individuals with high levels of internalized shame are more vulnerable to social exclusion. Finally, the implications, significance, and limitations of this study are discussed.
The Relationship between Level of Therapist Support and Efficacy and Adherence in Internet-Based Cognitive Behavioral Therapy for Disordered Eating Behaviors
Seyeom Kim, Eun-Jung Shim
STRESS. 2024;32(1):29-37.   Published online March 28, 2024
DOI: https://doi.org/10.17547/kjsr.2024.32.1.29
  • 1,491 View
  • 44 Download
Abstract PDF
Background
Therapist support is an important intervention design factor in internet-delivered psychotherapy. However, the relationship between therapist support and intervention outcomes is not well established. This study examined the relationship between therapist support, efficacy, and adherence to Internet-based Cognitive Behavioral Therapy (I-CBT) for disordered eating behaviors.
Methods
Thirty-six women with disordered eating behaviors were recruited and randomly assigned to three groups: low, medium, and high levels of therapist support. The participants received eight sessions of I-CBT, twice a week, with varying levels of therapist support.
Results
While all three groups showed a reduction in eating disorder risk factors (i.e., body image disturbance, disordered eating behaviors, depression, and anxiety), there were no significant differences in these improvements by therapist support level. However, there were significant differences in intervention completion rates by therapist support level, with higher levels of support associated with increased intervention completion rates.
Conclusions
Therapist support can potentially improve adherence to internet-based interventions.
Test Linking of Suicide Risk Assessment Instruments: Comparing Cut-Off Scores for Suicide Risk
Hwajeong Yu, Yuhwa Han, Sungeun You
STRESS. 2023;31(1):25-36.   Published online March 31, 2023
DOI: https://doi.org/10.17547/kjsr.2023.31.1.25
  • 7,890 View
  • 258 Download
Abstract PDF
Background
Communicating the objective meaning of the cut-off criteria for high-risk among suicide risk assessment tools is challenging because they measure different aspects of suicide risk. This study aimed to provide comparable scores among widely used suicide assessment instruments by using test linking.
Methods
Linking was performed using the equipercentile method with the data of 400 adults. Then, for an independent sample of 165 adults, the validity of linking was tested by providing an overall percent agreement of group classification.
Results
Linking results indicated that the score of 4 on the C-SSRS corresponded to 8 on the DSI-SS and 16 on the SBQ-R, respectively. The overall percent agreement of group classification based on the cutoff score of 4 on the C-SSRS was high in both scales, supporting the validity of linking.
Conclusions
The study results provide comparable criteria for the high-risk group among the three measures. Mental health practitioners could utilize our results in identifying people at high suicide risk.
Comparison of Stroke Knowledge, Health Beliefs, and Stroke Prevention Behavior between Early and Middle-Aged Adults
Eun Ko
STRESS. 2022;30(2):98-108.   Published online June 30, 2022
DOI: https://doi.org/10.17547/kjsr.2022.30.2.98
  • 3,735 View
  • 133 Download
Abstract PDF
Background
The onset age of stroke is decreasing, leading to social loss. As such, primary stroke prevention is important. This study aimed to compare the stroke knowledge, health beliefs, and stroke prevention behavior between early and middle-aged adults.
Methods
In this cross-sectional descriptive study, a survey was conducted in three small cities in Korea from June to October 2020. The study used a structured self-report questionnaire that included items on stroke knowledge, including risk factors, warning signs, and urgent action, health beliefs, and stroke prevention behavior, as well as collected data on respondents’ demographic characteristics. The data were analyzed with descriptive statistics, t-test, 2 test, and Pearson’s correlation coefficients using IBM SPSS Statistics for Windows, Version 26.0.
Results
The participants included 104 early adults (aged below 40 years) and 143 middle-aged adults (aged 40∼64 years). The two groups showed a significant difference in their health beliefs scores. By contrast, they did not show a significant difference in their scores for stroke prevention behavior. However, their scores for health responsibility (t=−2.00, p=.047), nutrition (t=4.24, p<.001), and interpersonal relationships (t=2.04, p=.042) were significantly different.
Conclusions
Early and middle-aged adults showed differences in health beliefs and the stroke prevention behavior subfactors of health responsibility, nutrition, and interpersonal relationships. The present findings may be used when planning interventions or education programs for primary stroke prevention.
Influences of Physical Symptoms, Sleep Quality, Fatigue and Health Promoting Behaviors on Job Satisfaction of Shift Nurses
Young Eun Ahn
STRESS. 2021;29(4):262-270.   Published online December 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.4.262
  • 4,330 View
  • 359 Download
  • 3 Citations
PDF

Citations

Citations to this article as recorded by  
  • Mediating effects of fatigue on the relationship between sleep quality and the quality of life of shift-working nurses
    Jeongwon Yeom, Insun Yeom
    Chronobiology International.2023; 40(4): 450.     CrossRef
  • Effects of perceived spiritual management, work engagement, and organizational commitment on job satisfaction among clinical nurses: the mediating role of perceived spiritual management
    Eun-Hye Lee, Hea-Jin Yu
    BMC Nursing.2023;[Epub]     CrossRef
  • The Effects of Optometrist’s Job Satisfaction on Fatigue Symptoms
    Hye-Kyung Hwang, Jeong-Yun Lee
    Journal of Korean Ophthalmic Optics Society.2022; 27(3): 153.     CrossRef
Effectiveness of Rational Emotive Behavior Therapy Program Utilizing Literature for Mental Health of Menopausal Women
Yeong-Seon Hong, Kuem-Sun Han
STRESS. 2021;29(4):250-261.   Published online December 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.4.250
  • 2,929 View
  • 166 Download
  • 2 Citations
PDF

Citations

Citations to this article as recorded by  
  • Factors Influencing Suicidal Ideation in Middle Aged Adults: Focused on Gender Differences
    Jaerin Kim, Kuem Sun Han
    Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(1): 45.     CrossRef
  • A Structural Equation Model of Subjective Happiness in Menopausal Middle-aged Women
    Soo Yeon Lee, Kuem Sun Han
    Journal of Korean Academy of psychiatric and Mental Health Nursing.2023; 32(3): 340.     CrossRef
Effects of Stress on Suicide Behavior among Adolescents: An Analysis of Online Survey Data on Youth Health Behavior Using Propensity Score Matching
Chung Hee Woo, Ju Young Park
STRESS. 2021;29(3):199-205.   Published online September 30, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.3.199
  • 2,634 View
  • 91 Download
PDF
Effectiveness of a Cognitive-Behavioral Stress Management Program on Psychosocial Stress, Mood State, and Ways of Coping for Emergency Department Nurses
Ja-Hyun Kim, Kuem-Sun Han
STRESS. 2021;29(2):87-96.   Published online June 30, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.2.87
  • 3,323 View
  • 317 Download
  • 1 Citations
Abstract PDF
Background

The study was undertaken to evaluate the effects of a cognitive-behavioral stress management program on psychosocial stress, mood states, and ways of coping with stress for emergency department (ED) nurses.

Methods

The study design was a non-equivalent control group with a pre/post design. The study was conducted from July 1, to September 30, 2016. The sample population comprised nurses who work in ED in Seoul, South Korea. The sample size was 79 which included 39 in the experimental group and 40 in the control group. Seven sessions of a program (50 minutes/session) were provided over 4weeks. Data were analyzed using descriptive statistics: the χ2-test and the t-test with the SPSS/WIN 21.0 program.

Results

There were statistically significant differences in psychosocial stress, mood states, and ways of coping with stress between the experimental group and the control group. However, the sub-hypothesis regarding the degree of using passive coping skills was not supported.

Conclusion

The results of this study indicate that a cognitive-behavioral stress management program for ED nurses is effective in reducing psychosocial stress, changing mood states positively, and improving ways of coping with stress effectively.

Citations

Citations to this article as recorded by  
  • Effects of Auricular Acupressure on Nurses’ Perceived Stress, Sleep Quality, and Presenteeism
    Hyunseo Sim, Younghee Park
    Holistic Nursing Practice.2025; 39(1): 15.     CrossRef
A Study on Attitude toward Suicide, Suicidal Ideation, Suicidal Behaviors in People with Mental Disorders in Community
Keun Young Park, Ji Young Kim
STRESS. 2021;29(1):60-67.   Published online March 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.1.60
  • 1,768 View
  • 70 Download
Abstract PDF
Background

This study aimed to examine the correlations among attitudes toward suicide, suicidal ideation, and suicidal behaviors in people with mental disorders.

Methods

A descriptive research design was used. The participants were 172 patients with mental disorders selected from 12 mental health care facilities located in J and C Provinces in Korea. The study employed Attitudes Toward Suicide, the Scale for Suicide Ideation, and the Columbia-Suicide Severity Rating Scale, using the SPSS WIN 23.0 program for data analysis.

Results

Attitudes toward suicide obtained 2.56 points out of five on average, 7.21 points out of 38 on suicidal thoughts, and 1.91 points out of four on suicidal behaviors. A attitudes toward suicide of people with mental disorders were significantly correlated with suicidal ideation and suicidal behavior.

Conclusions

This study suggested that the development of education programs for reducing suicidal ideation and behaviors should be based on the appropriate attitudes toward suicide of people with mental disorders in the community.

Distractive Emotion Regulation: The Construct and Its Measurement
Dohyeon Kim, Hae Youn Choi
STRESS. 2021;29(1):11-20.   Published online March 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.1.11
  • 3,000 View
  • 54 Download
Abstract PDF
Background

Distractive emotion regulation, which relieves arousal through attention shift, protects individuals from strong stress. Distractive emotion regulation is widely used in everyday life and although it has great implications in the context of adaptation such as to addiction, it is generally not considered separately from avoidant regulation, it has neither been clearly defined nor measured.

Methods

Through a literature review and qualitative analysis, we selected adults’ distractive emotion regulation behaviors. We explored the construct by developing measurement on the distractive behaviors that adults use to regulate emotion.

Results

Factor analysis revealed that distractive emotion regulation consisted of four factors: “consumption distraction” concerned with activities such as shopping, internet use, and TV viewing; “arousal control distraction” related to activities such as exercise, bathing, and deep breathing; “reserving distraction” pertaining to activities such as eating, sleeping, and listening to music; and “aggressive distraction” involving behaviors such as bullying, physical destructiveness, or cursing. Each factor had a different correlation with stress coping dimensions and subjective well-being.

Conclusions

Distractive emotion regulation is a multidimensional concept composed of sub-factors with different functions and clinical implications in daily life.

Relationship between Complex Trauma Experience in Childhood-Adolescence and Interpersonal Trauma in Adulthood: Mediating Effects of Dissociation Experience, Relationship Addiction, and Internalized Shame
Yumi Oh, Min Kyu Rhee
STRESS. 2021;29(1):1-10.   Published online March 31, 2021
DOI: https://doi.org/10.17547/kjsr.2021.29.1.1
  • 2,581 View
  • 138 Download
Abstract PDF
Background

The purpose of this study is to verify the mediating effects of dissociation experience, relationship addiction, and internalized shame in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood.

Methods

Two hundred and thirty-eight adults participated in this study. They were administered the Korean versions of the Trauma Antecedents Questionnaire, Impact of Event Scale-Revised, Dissociative Experiences Scale, Relationship Addiction Questionnaire, and Internalized Shame Scale. The data were analyzed with descriptive statistics, correlation analysis, reliability analysis, and structural equation modeling.

Results

First, dissociation and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Second, relationship addiction and internalized shame had a double mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood. Third, dissociation, relationship addiction, and internalized shame had a triple mediating effect in the relationship between complex trauma experience in childhood-adolescence and interpersonal trauma in adulthood.

Conclusions

Therapeutic intervention for revictimization should address symptoms such as dissociation, relationship addiction, and internalized shame. In addition, people with complex trauma experiences in childhood-adolescence require preventive intervention to avoid further exposure to interpersonal trauma.

Effect of Body Image Distortion on Health Behaviors Practice in High School Students
Hyun Jung Yun
STRESS. 2020;28(2):98-105.   Published online June 30, 2020
DOI: https://doi.org/10.17547/kjsr.2020.28.2.98
  • 2,803 View
  • 146 Download
Abstract PDF
Background

The purpose of this study was to examine the effect of body image distortion on health behaviors practice in high school students.

Methods

This study used a secondary data analysis study with the data derived from the 2019 Korea Youth Risk Behavior Web-based Survey. The study sample included 20,787 high school students. Collected data were analyzed with SPSS program using Rao-Scott x 2 test and complex samples general linear model analysis.

Results

The prevalence of adolescents with body image distortion was 24.5% in this study. Health behaviors practice had significant differences according to body image distortion (t=10.29, p<.001), and the score for health behaviors practice in adolescents with body image distortion was lower than those without body image distortion. Gender, grade, school type, school achievement, economic status, and perceived health state were found to be significantly related to health behaviors practice. After controlling significant variables, body image distortion (b=.14, p<.001) was significantly related to health behaviors practice in adolescents, accounting for 4.0% of the variance in health behaviors practice (Wald F=52.75, p<.001).

Conclusions

These findings suggest that body image distortion has negative effects on health behaviors practice and healthcare professionals need to consider enhancing body image for improvement of health behaviors practice in adolescents.

A Study on the Perceived Stress, Coping, and Personal Satisfaction according to DISC Behavioral Style of College Students
Seunghee Yang
STRESS. 2019;27(4):422-430.   Published online December 31, 2019
DOI: https://doi.org/10.17547/kjsr.2019.27.4.422
  • 2,334 View
  • 98 Download
Abstract PDF
Abstract Background:

College students experience stress related to its demands. Providing adequate resources to improve stress management remains a challenge. Dominance, Influence, Steadiness, Conscientiousness (DISC) is an instrument that accounts for multidimensionality of personality and has been used widely in research and industry. The purpose of this study was to examine DISC behavioral style with perceived stress, coping behavior, and personal satisfaction among college students.

Methods:

Data were collected from 255 college students using self-reported questionnaire. Univariate descriptive statistical analysis was performed to explore sociodemographic characteristics of the sample. Possible association between sociodemographic variables and perceived stress, coping, personal satisfaction were examined using bivariate analysis with T-tests for independent samples and Chi-square. ANOVA was used to assess possible association between DISC profiles and the following three variables: perceived stress, coping, and personal satisfaction. A Scheffe test was performed post hoc to test for differences in DISC behavioral style and measures of perceived stress, coping, and personal satisfaction.

Results:

The distribution of DISC behavioral styles were 49.4%, 23.2%, 18.8%, and 8.6% respectively for dominance, influence, steadiness, and conscientiousness. Perceived stress and personal relationship varied significantly with DISC behavioral style (p=.001 and p=.019 respectively). Variation in DISC behavioral style did not demonstrate a significant association with stress coping (p=.383).

Conclusions:

Providing stress coping management tailored to DISC behavioral style may be an effective way to improve stress reduction and personal satisfaction among college students.

Social Support Moderates the Impact of Pain-Related Threat on Avoidance Behavior
Ubin Yi, Sungkun Cho
STRESS. 2019;27(1):125-131.   Published online March 31, 2019
DOI: https://doi.org/10.17547/kjsr.2019.27.1.125
  • 1,835 View
  • 61 Download
Abstract PDF
Background:

According to the fear-avoidance model, pain becomes chronic when it is related to fear and avoidance behavior. When a pain-related threat occurs, humans instinctively use avoidance behavior strategies. However, the support of significant others is likely to inhibit avoidance behavior even with the same pain-related threat stimulus. Thus, in this study, we examined the effects of pain-related threats and social support of romantic partner on avoidance behavior inhibition.

Methods:

Participants consisted of 80 pairs of healthy undergraduate couples, and were randomly assigned to one of four group conditions in a 2×2 factorial design, with threat level (high/low) and social support (presence/absence) as factors.

Results:

The results of the experiment indicated a significant interaction between threat level and social support. Specifically, in the high-threat condition, when social support was provided, task delay time was significantly shorter than when no social support was provided. On the other hand, in the low-threat condition, the time delay difference between high- and low- social support group was not significant. Moreover, social support did not affect fear reduction.

Conclusions:

These results indicate that avoidance behaviors, which are instinctive responses to pain, can be inhibited by social support. This result would enhance understanding of the factors that have not been described in the fear-avoidance model in the pain-chronicization process, and will help expand and improve the model. We also discuss possible limitations of the study and scope for further studies.


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